AUA releases new clinical guidelines on ED

AUA released an update of its clinical diagnosis and treatment guidelines for erectile dysfunction during its recent annual meeting.

Following a thorough examination and complete medical history, oral PDE-5 inhibitors, intra-urethral alprostadil, intracavernous vasoactive drug injection, vacuum constriction devices, and penile prostheses should be considered for treating ED. The treatment choice would ideally be made jointly by the physician, the patient, and the patient's partner, the guidelines state.

The guidelines specifically address ED in patients with cardiovascular disease. They cite and support the Princeton Consensus Panel's recommendation that men at high cardiovascular disease risk should not receive ED treatment until their condition has stabilized. Patients at low risk should be considered for first-line therapies.

Unless contraindicated, PDE-5 inhibitors should be offered as a first-line of therapy for ED. Patients who have failed a trial with PDE-5 inhibitor therapy should be informed of the benefits and risks of other therapies.

"Depending on the patient population characteristics, as many as 80% of men will benefit from oral PDE-5 inhibitors," said Drogo Montague, MD, a co-chair of the panel that produced the guidelines. "For those men who are not helped by these agents, one or more of the remaining treatment options are almost always successful."